Alex Bierman

Current Issues and Future Directions in Research into the Stress Process

This chapter presents an overview of the stress process, which is the conceptual framework that examines the interrelationships among the stressors to which people might be exposed, and the mediating and moderating conditions that help to regulate the impact of the stressors on various aspects of people’s mental health. Of salient sociological importance, the stress process also takes into account the bearing of status placement on the stressors people experience, the mediating and moderating resources and conditions to which they have access, and the symptoms of mental health they manifest. Over the 30 years since its inception, it has helped to lead researchers to a greater understanding of the connections between mental health and its complex psychosocial causes. Yet, there are many gaps in this understanding, and some of these have been singled out here as promising targets for future research.

Timing, Social Support, and the Effects of Physical Limitations on Psychological Distress in Late Life

OBJECTIVES Previous research shows that limitations in activities of daily living (ADLs) are related to greater psychological distress. This study uses a synthesis of life course and stress process perspectives to examine how social support resources and the timing of limitations intersect to shape the relationship between ADL limitations and changes in psychological distress. METHODS Data are derived from a longitudinal study of adults aged 65 and older in the Washington, DC, metropolitan area over a 2-year period (2001-2003). RESULTS ADL limitations are positively related to change in depressive symptoms. This relationship is weakened for older individuals, but only at higher levels of perceived social support. DISCUSSION The contribution of this research is to offer a more nuanced view of the mental health consequences of physical limitations in late life by demonstrating that perceived social support provides an important context for age-variegated associations between ADL limitations and changes in psychological distress.

The Sociology of Mental Health: Surveying the Field

This chapter introduces the major themes of this handbook. These themes address how society shapes the thoughts, feelings, and actions of its members in ways that are considered to be mental illness, and the consequences of having, or being thought to have, a mental illness. This subject matter encompasses the medical model and alternative perspectives, including the social construction of mental illness, the medicalization of deviant states and behaviors, and the experiences and understandings of persons with mental illnesses. The sociological search for the causes of mental illness frequently examines how social inequality leads to disproportionate exposure to social stress, as well as limits the resources that might otherwise ameliorate the adverse effects of stress exposure. This etiological perspective also addresses how major social institutions, such as family, work, and religion, shape the likelihood of developing a disorder. An additional emphasis concerns the social consequences of disorder, such as, stigma, encounters with the legal system, and effects on the family. Finally, the handbook considers how mental health problems are arrayed over time in trajectories that have cumulative consequences for people’s lives.

Religion and Mental Health

In this chapter, we examine the relevance of religion for mental health. We review how prominent forms of religious involvement influence mental health indirectly through the accumulation of resources and by preventing or attenuating the association between stress exposure and unfavorable mental health outcomes. We also discuss how religious involvement may at times deleteriously impact mental health through increased exposure to specific stressors and maladaptive forms of coping. In this effort, we summarize major conceptual, theoretical, and empirical perspectives related to three specific themes: (1) religious activity, (2) religious belief, and (3) religion during times of stress and adversity. Although our focus is primarily on Judeo-Christian institutions, practices, and beliefs in the USA, in a discussion of future research directions, we describe emerging comparative work that examines religion and mental health in a cross-cultural context.

Pain and Depression in Late Life: Mastery as Mediator and Moderator

OBJECTIVES This study examines how mastery mediates and moderates the relationship between pain and depression among older adults, as well as the extent to which these processes differ by the timing of pain in late life, while utilizing statistical methods that comprehensively control for time-stable confounds. METHODS Data are derived from multiple observations of adults aged 65 years and older in the Washington, DC, metropolitan area over a 4-year period. Fixed effects models are used to control for time-stable influences. RESULTS With all time-stable influences controlled, pain is positively related to symptoms of depression, although this relationship is substantially reduced in comparison with a model in which all time-stable confounds are not held constant. Mastery does not mediate this relationship because pain is not significantly related to mastery once time-stable factors are taken into account. Mastery buffers the relationship between pain and depression, but only for elders later in late life. DISCUSSION This study suggests that a synthesis of stress process and life course perspectives is critical for understanding how pain influences depression in late life. However, research that does not comprehensively control for time-stable factors may overestimate the consequences of pain for older adults.

Ambivalence on the front lines perceptions of contractors in Iraq and Afghanistan

In the past several decades, the US military has increasingly relied on civilian contractors to provide a variety of core functions. Lagging behind this increased reliance on contractors is an understanding of how the presence of contractors influences civilian and military personnel. This research addresses this question using a unique study of US Department of Army civilians and military personnel serving in Iraq and Afghanistan. We find a substantial degree of ambivalence among both groups regarding the impact of contractors on the military and comparisons with contractors, but we also find a noticeable trend of comparative discontent beneath this apparent ambivalence. Results are discussed in the context of using ambivalence as a starting point for building a theoretical approach to more systematically understanding the role and effects of contractor integration in the military.

How does religious attendance shape trajectories of pornography use across adolescence

Research increasingly calls attention to the possibility of detrimental consequences of pornography use among adolescents. However, few studies examine adolescent pornography consumption longitudinally or consistently examine the role of religion in shaping pornography consumption, despite an established theoretical basis for the moderating effects of religious attendance on pornography consumption. Using a national longitudinal survey that follows respondents from adolescence into young adulthood, we show that pornography use increases sharply with age, especially among boys. Pornography consumption is weaker at higher levels of religious attendance, particularly among boys, and religious attendance also weakens age-based increases in pornography consumption for both boys and girls. Overall, pornography use increases across adolescence into young adulthood, but immersion in a religious community can help weaken these increases. Future research should follow respondents across adulthood, as well as examine additional aspects of religiosity (e.g., types of religious belief or the regular practice of prayer).

The Threat of War and Psychological Distress Among Civilians Working in Iraq and Afghanistan

Research documents the mental health toll of combat operations on military personnel in Iraq and Afghanistan, but little research examines civilians who work alongside members of the military. In this research, we argue that a sense of threat is an “ambient stressor” that permeates daily life among civilians who work in these war zones, with mastery likely to both mediate and moderate the mental health effects of this stressor. Using a unique probability sample of Department of Army civilians, we find that threat is positively related to distress, but mastery mediates this relationship nonlinearly, with the indirect relationship between threat and distress strengthening as threat increases. The moderating function of mastery is also nonlinear, with moderate levels of mastery providing maximum stress buffering. This research suggests that contextual conditions of constraint can create nonlinearities in the way that mastery mediates and moderates the effects of ambient stressors.

Functional Limitations and Psychological Distress Marital Status as Moderator

This research examines how marital status modifies the relationship between functional limitations and two aspects of psychological distress—depression and anger. Analyses of a multiwave national probability survey show that marriage weakens the relationship between functional limitations and depression, but this moderation is specific to older men. Functional limitations are not significantly related to anger once time-stable confounds are comprehensively controlled, and this association does not differ by marital status. This research shows that marriage may benefit mental health by preventing the deleterious effects of chronic stressors, but marital status intersects with additional social statuses and a life course context in creating these modifying effects. In addition, research that does not consider both internalizing and externalizing mental health outcomes and comprehensively take time-stable confounds into account may present an incomplete depiction of the mental health consequences of stress and social arrangements.

Reconsidering the Relationship between Age and Financial Strain among Older Adults

Previous research documents a robust relationship between financial strain and psychological distress in older adults, but does not clearly indicate whether financial strain changes with age in late life. We show that age is positively related to financial strain when age and cohort effects are separated using growth curve modeling, and this relationship is masked in conventional regression models by a negative effect of birth cohort. Age-related increases are stronger among women and elders with lower levels of education, but weaker when individuals were born substantially before or at the end of the Great Depression. This research demonstrates that many older adults are increasingly exposed to a pernicious socioeconomic stressor as they age, but these increases are circumscribed by placement in a matrix of historical and structural circumstances. Furthermore, analyses that do not distinguish between age and cohort effects may fail to detect these increases.